On the importance of intracranial air

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Abstract
1. The presence of air within the skull (aerocele, pneumocephalus) indicates that a fistula communicates to the exterior. Without operative repair 25 per cent of patients will develop meningitis as dural tears heal poorly. 2. Coexisting cerebrospinal fluid leakage occurs in only half of the patients with aerocele. 3. The appearance of an aerocele may be delayed for days, weeks, or even years after head injury. 4. Patients who after head injury complain of severe headache, have a fracture involving the paranasal sinuses, or who have a nasal discharge should have at least a brow-up lateral skull radiograph with a horizontal beam. 5. While awaiting a neurosurgical opinion penicillin and sulphadiazine should be given. 6. A Series of 41 cases of traumatic intracranial aerocele is presented.